Orlando! The Meaning and Impact of Mental Illness II

When I wrote the initial copy for this post it was entitled The Myth of Mental Illness. That was also the title of the 1961 book by Thomas Szasz that I hold in high regard. He questioned the foundation of psychiatry as do I. His case gets stronger as time passes.

The fact is, I chose to become a psychologist for reasons I’m still uncovering. Probably the chief among them was my need to deal with my mother’s severe depressions. They seem to have been the result of personality problems but mostly reflected a genetically based vitamin D deficiency. I had set out to study particle physics but an unforgivably bad calculus professor turned me off on the mathematics which I viewed as fundamental. And so I found my way into a field I’m still disputing.

Decades later I have concluded that the term mental illness should be relegated to the dustbin of history. Recently I saw that someone had come up with a “diagnosis” for people who are concerned about healthy eating. Diagnosing them has the implication of viewing such a justifiable concern as an aberration or some kind of deviation of behavior.

The Beginning

In college I found the study of psychology interesting but that there were two parts. The clinical people were usually over in the medical settings and the academic setting was closer to experimental studies. They declared psychology was a science. Early on I was not impressed by the science part. I could see philosophy among other things. In the end I went to Duke University to study experimental psychology but within days asked to move to the clinical program which they granted. Steadily I was introduced to psychology, psychiatry and psychotherapy.

I was not prepared for the authoritarian nature of psychiatry. I attended Grand Rounds and saw patients paraded on stage while their history of “mental illness” was presented and discussed. (I should say this was decades ago and things have probably changed.) I also learned that psychiatric residents were not permitted to declare a diagnosis. A senior staff member would step forward and deliver the definitive word.

There were times when graduate students such as myself went to clinical meetings and presented findings from our testing. Our findings were frequently used to harass and haze both medical students and residents. The effect was to build a wall between psychiatry and medicine in general.

Learning By Doing

I realized after the fact that I often was given very difficult cases. One of them was a very pretty, very dysfunctional and hysterical young woman. In her interest I managed to get her diagnosis changed from schizophrenia to a less damaging diagnosis which meant she might get more flexible and dedicated treatment in the years ahead. But one day I got a call from the emergency room. I found her seated on a gurney. A terrified intern was in attendance. In front of her he informed me (and her) that if she had sliced at her arm and throat in a different direction that she would have bled to death. It seemed he had not been prepared for this kind of management.

My supervisor asked that I be very careful with this young woman and said he assumed she had already driven three therapists into research partly because of her extreme behavior and seduction efforts. Her late night forays and partying led to a pregnancy and she wanted an abortion. The nature of the times was such that she had to seek out senior psychiatric staff on her own and plead for a diagnosis to permit an abortion. She was unsuccessful.

We struggled on and she managed to achieve more stable functioning. I assumed there would be a long road ahead. In all regards I found the system deeply flawed.

Moving On

After graduation I went to Baltimore to work in a community mental health program. Our group of dedicated twenty somethings formulated reality based approaches for the people of the community and were faced with obstruction by our seniors in that they had a much deeper self serving agenda.